Public Health Spotlight S2 EP7 – Colin Cox

Managing Public Heath in Urban vs Rural Communities 

In this episode of the Public Health Spotlight podcast, Colin Cox, Director of Public Health and Customer & Community Wellbeing for Cumberland Council, joins Callum Gardiner to share insights from a career spent navigating the evolving landscape of public health across both urban and rural settings. From grassroots addiction work in Stockport to transformative leadership roles in Manchester and Cumbria, Colin’s journey is a testament to the power of partnership, adaptability, and people-first innovation.

A Career Shaped by Breadth: From Substance Misuse to System-Level Change

Colin’s passion for public health began on the frontline, tackling addiction and witnessing the complex network of factors that influence health and wellbeing. His early work in Stockport opened his eyes to the “huge breadth of possibility” that public health offers. Whether focused on environmental issues, behavioural psychology, or partnership working within local authorities, Colin reflects that public health “is a world to whatever you’re interested in.”

Transforming Challenges into Opportunity: Lessons from Manchester

At Manchester City Council, Colin became part of one of the UK’s most forward-thinking joint health units—an integrated NHS and local authority team working across traditional organisational boundaries long before public health formally moved into local government. Here, he saw how strong leadership, a shared purpose, and committed people can deliver meaningful change for some of the most deprived communities in the country. Standout initiatives such as Food Futures and the Valuing Older People strategy brought together agendas around health, environment, and the local economy, while championing older residents as vital contributors to society.

Leading Through Change: Rural Inequality and System Restructures

Stepping into the role of Director of Public Health in Cumbria, and later leading Cumberland through local government reorganisation, Colin experienced a dramatic shift—from dense urban Manchester to the dispersed and often “hidden” challenges of rural Cumbria. He reflects on the realities of serving ageing populations, the importance of good data combined with local knowledge, and the pressure of managing a major council split. The restructure was both “hard and sad”, demanding the rebuilding of teams, services, and capacity with fewer resources, but it also opened new space to influence strategy at the highest level.

Collaboration, Culture, and Putting Wellbeing at the Centre

Now overseeing public health, customer services, environmental health, and community development, Colin has shaped a directorate with wellbeing “at the heart of everything we do.” He highlights the impact of bringing teams together in one directorate—breaking down silos and enabling genuinely preventative, people-centred public services. From empowering frontline staff to respond holistically to resident needs, to strengthening local nature partnerships, Colin demonstrates how leadership decisions can have a lasting positive effect on community outcomes.

Advice for the Next Generation

For those looking to step into public health leadership, Colin offers grounded, practical advice: embrace opportunities, take yourself a little less seriously, and remember that leadership is about shaping outcomes and supporting your teams. Careers in public health are rarely linear, but by focusing on collaboration, adaptability, and enabling others, you can create “an environment in which people work to get the best out of people.”

Listen now to hear Colin Cox’s reflections on leading through system change, championing community collaboration, and balancing a broad strategic portfolio—capturing the dynamic, ever-adapting nature of public health leadership in Cumberland.

Ready to explore further?

Listen to the full episode of Public Health Spotlight – Managing Public Health in Urban vs Rural Communities for deeper insights into resilience, innovation, and the lived realities of driving public health in times of change.